Antitubercular Agents ; standards ; Child ; Humans ; Tuberculosis ; drug therapy ; prevention & control

SUMMARY In recent years, successful pregnancies in renal transplant women have been reported worldwide. However, pregnancy in renal trasplant recipient is relatively rare in China. This paper reported a case of pregnancy 2 years post renal transplant. At the end of 28 weeks' gestation she had abnormal liver and renal function complicated with severe preeclampsia. Literatures were reviewed on considerations about pregnancy in renal transplant women. Maternal and neonatal outcomes can be improved by intensive care during pregnancy, proper immunosupression and timely termination of pregnancy.

Objective To explore the activity signs and clinical value of CT in evaluation of anti -tuberculosis chemotherapy in elderly patients with active tuberculosis.Methods Clinical and imaging data of 78 cases with elderly active tuberculosis were retrospectively analyzed.The changes of CT sign between bacterium negative and posi-tive,before and after chemotherapy were compared.Results The detection rates of ground glass opacity,thick -walled cavity in bacterium positive were 72.1% and 55.8%,which were significantly higher than those in bacterium negative 45.7% and 28.6%(P <0.05).Compared with before chemotherapy,the detection rates of ground glass opacity,tree -in -bud,thick -walled cavity,pulmonary consolidation,centrilobular nodule,lobular consolidation after chemotherapy were significantly reduced(P <0.05).The active CT signs of ground glass opacity,tree -in -bud were completely absorbed,and other signs were lapsed to non -active signs including cord -like shadow,thin -walled cav-ity,calcification,bronchia aggregation and circuity.Conclusion There is conversion rule of CT signs in elderly active pulmonary tuberculosis before and after anti -tuberculosis chemotherapy,and CT is helpful in the evaluation of anti -tuberculosis chemotherapy results of active tuberculosis.

Objective To develop a Chinese version of Death Attitude Proevaluate its reliability and validity by applying it in the Chinese Christians.Methods After undergoing forward and backward translation of the DAP-R by expert consultation and in-depth interview,150 Christians over 40 years old were recruited to complete the Chinese version of DAP-R,And then factor analysis,correlation analysis and reliability analysis were applied to establish the scale's construct validity and reliability.Results The final scale consisted of five dimensions with 25 items; the varimax rotation factor analysis of the scale identified seven principal factors and explained for 67.075% variances; the correlation coefficient between each item and its domain was 0.432～0.850; Cronbach's α coefficient of five domains were 0.585～0.853,the Cronbach's α and split-half coefficient for the whole scale were 0.840 and 0.843 respectively.Conclusions The Chinese version of DAP-R possesses acceptable validity and reliability in the setting of Christians,and more in-depth study on the scale needs to be done in a wider population.

Gene therapy of spinal cord injury (SCI) is the most promising method compared with the others, because it doesn't involve the problems of resource and higher exclusion which respectively exists in fetal nerve transplantation and peripheral nerve transplantation. There are two ways of gene therapy to be chosen: one is to transfer objective genes to the target-cells in vivo directly; the other is to transfer objective genes to one proper kind of transplantable cells firstly, then graft the highest expressing cells to the target-cells in vivo. To realize the transfer of genes to cells, two measures are used in common: physical or chemical measure such as micro infection et al and biochemical measure i. e. gene modified defective virus. Although there are some questions unresolved in this field, the clinical value of gene therapy of SCI in the future is depended.

Objective To investigate the correlation between urinary calculi and upper urinary tract infections.Methods Twenty-six patients underwent lithiasis in upper urinary tract accompanied with infectious symptoms were enrolled in this study (test group).Blood culture was obtained in peak temperature before lithotrity,urine sample was obtained for bacterial culture.Thirty patients with calculi in upper urinary react accompanied no infectious symptoms in the same period were enrolled in control group.Calculi were pestled for bacterial culture and analyzed the components after the calculi were removed.Results In test group,the positive of blood,urine,calculi culture were 4,23,18 patients.The prominent component of calculi was hexahydrate magnesium ammonium phosphate.Bacteria in 13 positive urine sample had the same property with the calculi samples which came from the same cases.In control group,the positive of urine,calculi culture were 4,4 patients.The prominent component of calculi were calcium oxalate calculi and uricite calculi.The morbidity of upper urinary tract infections in test group was significantly higher than that in control group [69.2％(18/26) vs.13.3％(4/30)] (P ＜ 0.05).The coincidence of urine culture and calculi culture in test group was significantly higher than that in control group [72.2％(13/18) vs.25.0％(1/4)](P＜0.05).Conclusions Infectious calculi can easily result in upper urinary tract infections.Hexahydrate magnesium ammonium phosphate can make the prominent component in infectious calculi.

Objective To explore the effect of ceftriaxone combined with rifampicin in the treatment of children with purulent meningitis,thus to provide reference for related studies.Methods 120 children with purulent meningitis were selected and randomly divided into observation group(67 cases) and control group (53 cases) according to the digital table.The control group received treatment of ceftriaxone,and the observation group received ceftriaxone and rifampicin.The clinical effect,recovery time of clinical indicators,total protein (TP),C-reactive protein (CRP),and serum protein C level were observed in the two groups.Results After treatment,the total effective rate of the observation group was 97.01%,which was higher than 86.79% of the control group,the difference was statistically significant(x2=4.457,P<0.05).The recovery time of body temperature,peripheral leukocyte count,and CSF leukocyte in the observation group were (2.35±0.68)d,(5.27±1.56)d,(13.27±1.71)d,respectively,which in the control group were shorter than (3.36±0.36)d,(7.24±2.09)d,(16.74±2.66)d,respectively,the differences were statistically significant(t=-9.713,-5.926,-8.643,all P<0.05).After treatment,the TP and CRP decreased in two groups,serum protein C was increased,and the above indicators of the observation group improved more significantly,there were statistically significant differences(all P<0.05).There was no significant differences in the incidence of complications between the two groups(P>0.05).Conclusion Ceftriaxone combined with rifampicin in the treatment of children with purulent meningitis can reduce inflammation and promote the recovery time of clinical indicators,and it's worthy of reference.

Objective To evaluate therapeutic effects of hyperthermia therapy in combination with chemotherapy for the treatment of nonsmall cell lung carcinoma. Methods Fifty-two patients with non-small cell lung carcinoma underwent hyperthermia therapy in combination with chemotherapy(NP regimen) in this hospital between September 2003 and November 2006.The therapeutic effects were evaluated after 3 cycles of the combination therapy,and were compared with those from 16 patients receiving only chemotherapy between January 2006 and November 2006.Results The combination therapy offered significantly better curative short-term effects than the simple chemotherapy.The total response rate was 65.4%(34/52) for the combination therapy and 37.5%(6/16) for the simple chemotherapy(Z=-2.419,P=0.016).Significant pain relief was achieved in patients after the combination therapy,while no analgesic effect was noted after the simple chemotherapy,the difference between the two groups of patients being statistically significant(Z=6.486,P=0.000).There was no significant difference in the incidence of complications between the two groups,which mainly included nausea,granulocytopenia,thrombocytopenia,and abnormal liver functions.Conclusions Hyperthermia therapy in combination with chemotherapy compares favorably to simple chemotherapy in the treatment of non-small cell lung carcinoma.

Objective To evaluate the early diagnosis value of blood neutrophil gelatinase-associated lipocalin (NGAL) and interleukin-18 (IL-18) in patients with sepsis-induced acute kidney injury (AKI). Methods A prospective case controlled study was conducted. Fifty-six patients with sepsis but without renal disease admitted to intensive care unit (ICU) of Shanxi People's Hospital from April 2014 to April 2015 were enrolled. Blood lactic acid and acute physiology and chronic health evaluation Ⅱ (APACHE Ⅱ) score at ICU admission were recorded. The urine output, blood urea nitrogen (BUN), serum creatinine (SCr), NGAL, IL-18 and tumor necrosis factor-α (TNF-α) were continuously monitored for 48 hours. The patients were divided into AKI group and non-AKI group according to the diagnostic criteria of Kidney Disease: Improving Global Outcomes (KDIGO). The changes trend in above parameters between the two groups at different time points were compared. The early diagnostic value of NGAL, IL-18, and SCr for sepsis-induced AKI was evaluated by receiver operating characteristic curve (ROC). Results Compared with non-AKI group, with the time prolongation after ICU admission, the traditional parameters reflecting AKI urine output in sepsis-induced AKI group was decreased gradually, BUN and SCr were gradually increased, and a statistically significant difference was found at 12 hours between the two groups [BUN (mmol/L): 11.8±3.5 vs. 8.2±3.5, SCr (μmol/L): 88.6±11.3 vs. 74.0±11.0, both P < 0.01]; but the new indicators NGAL and IL-18 reflecting AKI had a statistically significant difference at 6 hours [NGAL (μg/L): 426.7±90.7 vs. 382.3±67.9, IL-18 (ng/L): 75.7±9.3 vs. 70.9±7.3, both P < 0.05]. It was shown that in AKI group, NGAL and IL-18 compared with BUN and SCr increased at least 6 hours ahead of schedule. The area under ROC curve (AUC) of 6-hour NGAL and IL-18 in patients with sepsis-induced AKI were 0.821 [95% confidence interval (95%CI) = 0.713-0.931] and 0.719 (95%CI = 0.584-0.853) respectively, superior to SCr (AUC = 0.677, 95%CI = 0.528-0.825). The cutoff value of NGAL was 363.58 μg/L, and the sensitivity and specificity were 88.0% and 86.7% respectively. Conclusions NGAL and IL-18 in the early prediction of sepsis patients with AKI are better than SCr, and NGAL was most sensitive. Therefore, NGAL can be used as an early biomarker for the diagnosis of AKI in patients with sepsis.

Objective: To analyze the application status of the EQ-5D and SF-6D in cost-utility analysis ( CUA) . Methods: The data from PubMed data base from 2003-2012 was conducted as the main resource in econometric analysis. Results: There is no certain increasing trend of literature quantity in the recent 10 years’ application of EQ-5D and SF-6D in the CUA. The main published language was English and the main country was the United Kingdom. The core authors of researches on the CUA estimated by EQ-5D and SF-6D had not been formed, however, the core periodicals had been formed. The literatures involve wide-spread diseases, mainly known as Motion system and pain diseases. Most of the effectiveness could be calculated with quality adjusted life year ( QALY) , the object of CUA is mainly on the medicine, operation and health intervention. Conclusion: Appicating EQ-5D and SF-6D in CUA and research content of the literatures has wide distribution width, although it has shown centralized trend, which still needs more studies by related researchers.